Malignant proliferating trichilemmal tumour and CAV (cisplatin, adriamycin, vindesine) treatment

Sir, Malignant proliferating trichilemmal tumour (MPTT) is a very rare neoplasm originating from the hair follicle, which often shows high malignancy.1 Although some reports recommended surgical removal as the principal method of treatment,2–4 reliable strategies for treating this type of malignant tumour have not yet been established. We report a patient with a highly advanced MPTT of the neck, which was treated with chemotherapy. A 56‐year‐old woman had noticed a subcutaneous tumour at her right submandibular region. Over 3 years it gradually grew in size, to become 3 cm in diameter. Pathological examination at a previous hospital had led to the diagnosis of benign calcifying epithelioma. After surgical removal the tumour soon recurred, and extended up to her right subauricular region and down to the neck within 4 months. A second surgical operation for removal of the tumour was performed, under general anaesthesia, at the first hospital. Many tumours of various sizes (1–3 cm) were found in the neck. These formed large aggregates which adhered to the crucial vessels and could not be removed completely. After the second operation, she came to the Osaka City University Hospital for treatment of the residual tumour.